Dr. Grossi's Blog

Drug abuse is constantly changing and presents evolving therapeutic challenges to psychiatrists and other treating providers. In about the last eighteen months especially, "bath salts" or "plant food", have burst on the scene aided by the electronic marketplace, the internet, and the rapid movement of information. They are named for their white crystalline-pellet appearance and are the latest abusable substances. They are synthetic derivatives of cathinone, a naturally occuring psychostimulant found in the khat plant. Natives of East Africa and the Arabian peninsula (mostly unmarried men in their 20s) have chewed the leaves of this plant for centuries to experience stimulation and relaxation.The most prevalent active ingredients are mephedrone, methylone, and methylenedioxypyrovalerone. They have amphetamine-like properties and will increase alertness, increase musical sensations, heighten libido and sexuality, euphoria, and relaxation. These are caused by the rapid release and reuptake blockade of dopamine, serotonin, and norepinephrine. The drug can be ingested, injected, smoked, or inhaled and they produce their effect in less than one hour.

Bath salt intoxication is a medical and psychiatric emergency. Auditory and visual hallucinations, delusions, paranoid thinking, agitation, and disorientation are common psychiatric symptoms. Physical symptoms can include hypertension, hyperthermia, diaphoresis, tremors, hypereflexia, clonus, ocular clonus, flushed skin, and muscle breakdown which can cause kidney damage. The physical signs sound like serotonin toxicity as described in the blog, MAOI and Drugs.That fits the data as mephedrone can cause a tenfold increase in serotonin level. The psychotic signs are likely related to a sudden rise in dopamine and the neurovegetative signs are serotonin and norepinephrine related.

In short, bath salts are extraordinarily dangerous and could even be fatal. Do not use under any circumstances.